MEDICARE: DR. CARLOS ENRIQUE QUEZADA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	P0471	TX

General Provider Information

NPI Number	:	1437115698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS ENRIQUE QUEZADA M.D.

Provider Business Mailing Address
First Line	:	590 MEDICAL CENTER ROAD
Second Line	:	WOMEN'S HEALTH CLINIC
City	:	FT CAVAZOS
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	254-553-1552
Fax Number	:	254-288-8109

Provider Business Practice Location Address
First Line	:	590 MEDICAL CIRCLE DRIVE
Second Line	:	WOMEN'S HEALTH CLINIC CRDAMC
City	:	FT CAVAZOS
State	:	TX
Zip	:	76554
Country	:	US
Telephone Number	:	254-553-3772
Fax Number	:	254-288-8610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	06/30/2025

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